A 28-year-old woman with type 1 diabetes presents with abdominal pain, vomiting and lethargy. Capillary glucose is 24 mmol/L. Venous blood gas shows p...

Question

A 28-year-old woman with type 1 diabetes presents with abdominal pain, vomiting and lethargy. Capillary glucose is 24 mmol/L. Venous blood gas shows pH 7.18 and bicarbonate 12 mmol/L. Serum ketones are markedly elevated. What is the most important initial fluid management step according to DKA protocols?

Accepted Answer

Rapid infusion of 0.9% sodium chloride intravenously

Answer

Restrict fluids to prevent cerebral oedema

Answer

Start 5% dextrose infusion immediately

Answer

Give bicarbonate infusion to correct acidosis

Answer

Administer hypotonic saline (0.45% sodium chloride)

au-acem MCQ (SBA): Diabetic ketoacidosis